MUMPS

Predisposing Factors Precipitating Factors

paramyxovirus -Discomfort in the -Weakened immune system
-Age group (infants, children
and teenagers) salivary glands or the -Close proximity to individual(s)
-Serology parotid glands - infected with Rubulavirus
-Sex (male and female)
-State of immunodeficiency -Virus Isolation transmitted by droplet Difficulty chewing -International travel to countries with
spread or by direct contact -Pain and tenderness no mumps vaccination program
of the testicles
-Fever
Other sites Primary sites viral replication -Headache -Acute pain r/t disruption of
-Muscle aches skin, tissue and muscle
-Tiredness integrity
Parotid gland Epithelium of -Loss of appetite -Imbalanced nutrition less
upper than body requirements r/t
CNS respiratory loss of appetite
-Disturbed body image
spreads to the related to the lesions and
Pancreas
local lymphoid during the two (2)
GI tract skin structure changes
tissue weeks following
Testis the onset of
clinical illness -
Ovarey Eye primary viraemia -Analgesics (e.g
Virus excreted in acetaminophen and ibuprofen)
few days after the onset of illness, virus the urine in
secondary
can again be isolated from the blood infectious form
viraemia
-Advise patient to rest when they feel weak
or tired
virus multiplication in target organs -Soothe swollen glands by applying ice
packs
-Advise to drink plenty of fluids to avoid
LEGEND dehydration due to fever
Predisposing factors Medical management -Let them eat a soft diet of soup, yogurt, and
Precipitating factors other foods that aren’t hard to chew
Clinical manifestations
Nursing considerations -Tell them to avoid acidic foods and
beverages that may cause more pain in
Disease process Diagnostic test
Nursing diagnosis salivary glands.

ELISHA ASLI C. SURATOS

BSN – II NA
 MUMPS
Mumps is a viral disease caused by the mumps virus. The virus is transmitted
by respiratory droplets or direct contact with an infected person. Only humans get and
spread the disease. People are infectious from about 7 days before onset of parotid
inflammation to about 8 days after. Once an infection has run its course, a person is
typically immune for life. Reinfection is possible, but the ensuing infection tends to be
mild. Mumps is preventable by two doses of the mumps vaccine. Most of the
developed world includes it in their immunization programs, often in combination with
measles, rubella, and varicella vaccine. Countries that have low immunization rates
may see an increase in cases among older age groups and thus worse outcomes.
Without immunization, about 0.1 to 1.0% of the population is affected per year.
Widespread vaccination has resulted in a more than 90% decline in rates of disease.
Mumps is transmitted by droplet spread or by direct contact. The primary site
of viral replication of the epithelium of the upper respiratory or the GI tract or eye. The
virus quickly spreads to the local lymphoid tissue and a primary viraemia ensues,
whereby the virus spreads to distant sites in the body. The parotid gland is usually
involved but so may the CNS, testis or epididymis, pancreas and ovary. A few days
after the onset of illness, virus can again be isolated from the blood, indicating that
virus multiplication in target organs leads to a secondary viraemia Parotitis is the most
frequent presentation, occurring in 95% of those with clinical symptoms. Occasionally,
meningitis may precede parotitis by a week. Virus is excreted in the urine in infectious
form during the 2 weeks following the onset of clinical illness. It is not known whether
virus actually multiplies in renal tissues or whether the virus is of haematogenous
origin. Life-long immunity is the rule after natural infection, but reinfections can occur
and 1 - 2% of all cases are thought to be reinfections.
Mumps is best known for the puffy cheeks and tender, swollen jaw that it
causes. This is a result of swollen salivary glands under the ears on one or both sides,
often referred to as parotitis. Other symptoms that might begin a few days before
parotitis include fever, headache, muscle aches, tiredness, and loss of appetite.
Symptoms typically appear 16-18 days after infection, but this period can range from
12–25 days after infection. Some people who get mumps have very mild symptoms
(like a cold), or no symptoms at all and may not know they have the disease. In rare
cases, mumps can cause more severe complications. Most people with mumps
recover completely within two weeks.
During mumps infection, several non-specific findings may be present in the
blood. The WBC may be low with lymphocytes predominating. ESR and CRP may be
normal or slightly elevated. Amylase levels may be elevated.
1. Serology: a serological diagnosis is usually made by finding a significant increase
in Ab titres in 2 serum samples taken 10 - 14 days apart. In some cases, the
detection of IgM may be used to diagnosis acute infection. Although only 1
serotype of mumps exist, cross-reactions between mumps virus and
paramyxovirus makes serological results difficult to interpret on occasions. Several
techniques are available:

ELISHA ASLI C. SURATOS

BSN – II NA
 a. CFT - the CFT is still the widely used for the diagnosis of mumps. Two antigenic
preparations are commonly used, the V antigen (consists mainly of HN
glycoprotein), and the S antigen (consists mainly of the NP). Antibodies against
S appear early and are short-lived, whilst antibodies to V antigens appear slowly
but persists longer. By comparing titers using the two different antigens, it is
often possible to make a serological diagnosis early in the course of illness.
b. HAI - this test measures antibodies similar to those reacting with the V antigen
in the CF test.
c. Neutralization test - virus neutralization has long been regarded as the most
reliable serological marker for immunity but is very tedious to carry out and thus
rarely used.
d. SRH - this technique has been adapted for use for the diagnosis of mumps.
e. Solid phase ELISA or RIA - various assays are available for the determination
of IgM and IgG. However, capture IgM assays are liable to interference from
Rheumatoid Factor. Elisa tests are useful in the measurement of mumps
antibodies in CSF. The greater sensitivity allows the determination of the exact
CSF/serum ratio and a ratio of greater than 100 signifies intrathecal synthesis.
However, the blood-brain barrier should be intact and proper controls should be
used. This may be an unrelated antibody or albumin.
2. Virus Isolation: virus isolation may be carried out by allantoic inoculation of 6 day
old embryonated eggs or by tissue culture methods. Virus can be isolated from the
CSF during the first 2 - 3 days after the onset of disease, and is present in urine
and saliva for 2 to 3 weeks. Monkey kidney cells are generally used for virus
isolation where a CPE is seen which consists of the formation of syncytia and the
focal rounding of cells. Virus identification can be performed by neutralization or
inhibition of haemadsorption by specific sera.
No specific treatment is available for mumps however, there are preventive
measures available.
The mumps vaccine is usually given as a combined measles-mumps-rubella
(MMR) inoculation, which contains the safest and most effective form of each vaccine.
Two doses of the MMR vaccine are recommended before a child enters school. Those
vaccines should be given when the child is between the ages of 12 and 15 months
and between the ages of 4 and 6 years. College students, international travelers and
health care workers in particular are encouraged to make sure they've had two doses
of the MMR vaccine. A single dose is not completely effective at preventing mumps.
A third dose of vaccine isn't routinely recommended. But your doctor might
recommend a third dose if you are in an area that is experiencing an outbreak. A study
of a recent mumps outbreak on a college campus showed that students who received
a third dose of MMR vaccine had a much lower risk of contracting the disease.

ELISHA ASLI C. SURATOS

BSN – II NA
REFERENCES
Galazka AM, Robertson SE, Kraigher A (1999). "Mumps and mumps vaccine: a global
review". Bull World Health Organ. 77 (1): 3–14. PMC 2557572. PMID 10063655.
Mumps. Centers for Disease Control and Prevention (May 29, 2015). Retrieved from:
http://www.cdc.gov/mumps/index.html Accessed March 09, 2016.
Categories: CS1 maint: Multiple names: authors listCS1 maint: PMC
formatDiseasePediatricsDermatologyViral diseasesOral pathology
Turkington C, et al. (2007). Hearing loss and infectious disease. The Encyclopedia of
Infectious Diseases. New York, NY: Facts on File, Inc.
Mumps. Retrieved from: https://virology-online.com/viruses/MUMPS.htm
Mumps. (September 26, 2018). Retrieved from: https://www.mayoclinic.org/diseases-
conditions/mumps/symptoms-causes/syc-20375361

ELISHA ASLI C. SURATOS

BSN – II NA